May 12, 2022
Get the FAQs about Automated Prior Authorization
by Susan Lawson-Dawson | Prior Authorization
Healthcare providers operate with razor-thin margins. Where can you shave down expenses? Increasingly, all eyes are on automated prior authorization. Prior authorization has been flagged as one of the most costly and time-consuming administrative processes in healthcare, and the burden keeps growing. With 4 out of 5 healthcare providers reporting that prior authorization requirements continued to increase in the past year, a more streamlined, automated process is certainly appealing. Want to know more about automated prior authorization before you make the leap? Check out these FAQs to learn more. What’s the difference between prior authorization (PA), electronic prior authorization (ePA)… Read entire article here
The Concept The concept behind coordination of benefits (COB) is fairly straightforward and simple. In situations where a patient has multiple health plans, it’s a way for commercial and government insurers to determine which payer is responsible for coverage, in what amount, and in what order — as a primary, secondary or tertiary payer. For instance, two spouses may pay for health insurance under each of their employer’s plans, so each would be covered under their plan and their spouse's plan. Or a single person may have Medicare and additional health care coverage under a supplemental plan. Coordination of benefits… Read entire article here
Healthcare is like any other service industry: provide the service, get paid. But unlike other service industries, a consumer (the patient) typically does not incur the cost of the service until weeks, months, or even years after it is rendered. Due to variations of inputs within a given visit or procedure and variables around payer contracted rates, the seller of the service (the doctor or provider) may not even know the cost of the service when it is rendered. Herein lies the problem. If a patient is unaware of how much is owed at the time he or she is… Read entire article here
